The Governor's Council on Disabilities and Special Education and the Alaska Mental Health Board (AMHB) share planning responsibility for services to children with serious emotional disturbances. The focus for the Governor's Council is school based. In the past, the AMHB's focus has been more on services outside school settings. To treat the child as a whole, we acknowledged the need to combine these approaches and to look at services in all environments used by children and their families. In Fiscal Years `97-`98, for the first time, the AMHB and the Governor's Council jointly agreed to plan for areas of overlapping responsibility. Members of the AMHB served on the Governor's Council's team to develop a Plan for Improving Services for Students with Severe Emotional Disturbances (February, 1997). The Children's Action Team for A Shared Vision II reviewed and recommended adoption of the goals contained in the Governor's Council plan. Re-formatted, these appear below. Fuller discussion of each of the goals appears in the Governor's Council document. Additional proposed actions are found in other places in the Children's Services section.
Goal 1: Eliminate inappropriate assessment and diagnosis bound services.
Discussion
Federal and state laws and regulations contain varying and incompatible definitions of "seriously/severely emotionally disturbed" children and youth, especially for those services provided by the Department of Education for special education services, the Division of Mental Health and Developmental Disabilities for mental health services, the Division of Medical Assistance for Medicaid payment for services and the Alaska Youth Initiative for intensive coordinated services. These varying definitions cause problems between the education community and mental health service providers in identifying and providing collaborative and comprehensive services for children with serious emotional disturbances.
Actions
95. The Governor's Council will work closely with the Division of Medical Assistance to develop a comprehensive and compatible definition of "seriously emotionally disturbed."
96. The Department of Education, Division of Family and Youth Services, Division of Mental Health and Developmental Disabilities, and Division of Medical Assistance will work with Alaska Youth Initiative providers to develop eligibility criteria which clearly incorporate the new Division of Medical Assistance definition of serious emotional disturbances while maintaining other necessary eligibility criteria.
97. The Governor's Council, school districts and the Alaska Department of Education will work together to modify, if possible, the definition of serious emotional disturbances as it appears in Alaska's Special Education regulations.
Goal 2: Comprehensive and collaborative systems will provide services to meet the needs of children, youth, and adults with and at risk of developing serious emotional disturbances.
Discussion
Alaska has services to support people with serious emotional disturbances. However, access can be problematic. Complex service systems and eligibility requirements can be confusing and intimidating. Services available from schools, agencies and other organizations may overlap or appear fragmented. In some communities, services may not exist or cannot be reached because of transportation difficulties.
Traditional systems approach clients as problems in need of treatment. Available services may not meet an individual's needs. Providers may be unaware of additional services being received by the client and family. Inefficiencies and overlap can be avoided through comprehensive and collaborative care that is community based. Partnerships need to be created across schools, families, service agencies, churches, businesses, local governments and other organizations. Members need to collaborate by communicating, sharing human resources, and/or co-funding activities. The outcome is that partners develop and implement comprehensive strategies to meet local needs in a more effective and cost efficient manner.
A comprehensive and collaborative system is also family centered. Family needs are shared with providers and are addressed by strategies developed by community partnerships. These services meet needs across the variety of major life activities.
Many projects and agencies exist with various service delivery models and various levels of community and cross discipline involvement. Improved communication and coordination are keys in achieving services that are comprehensive and collaborative.
Actions
98. The Alaska Mental Health Board, Governor's Council on Disabilities and Special Education and Alaska Mental Health Trust Authority will advocate for full funding of the continuum of services.
99. The Department of Health and Social Services and Department of Education will explore and implement a case manager model.
100. The Department of Health and Social Services and Department of Education will establish centralized communication and coordination strategies.
101. The Department of Health and Social Services and Department of Education will examine interpretations of laws and regulations to remove barriers to creating needed flexibility.
102. The Department of Health and Social Services and Department of Education will remove unnecessary barriers to accessing relevant client information while preserving needed confidentiality.
103. Local agencies and school districts will examine the current continuum of care to focus on early intervention.
104. Increase access to foster care and other care options, social and recreational activities, and programs for drug and violence-free communities.
105. Local communities and organizations will ensure parent involvement in and supervision of their children by educating families regarding the benefits of parent involvement and by supporting families in creating time with their children.
106. Develop understandable guide materials for parents, families and advocacy groups.
Goal 3: Expand treatment models available to school districts.
Actions
107. Use comprehensive, coordinated, collaborative service models that are school based, use mental health staff in schools and coordinate social services.
108. Make social skills training part of the regular school curriculum.
109. The Department of Education will train teachers to make more effective use of behavior plans.
110. The Department of Education will assist schools in using intervention assistance teams as an initial step in school behavior problem referrals.
111. The Department of Education, Division of Mental Health and Developmental Disabilities and Alaska Mental Health Board will support student directed interventions in schools (e.g., conflict mediation, peer counseling, student court).
112. The Alaska Department of Education, school districts and Project Spruce will train school counselors and school psychologists to be more effective in prevention, early intervention, consultation and staff development regarding serious emotional disturbances in children.
Goal 4: Expand resources available to parents and providers of services for children with serious emotional disturbances and their families.
Actions
113. The Alaska Mental Health Board, Governor's Council and advocacy groups will provide comprehensive formatted information for families accessing services.
114. Advocacy and professional groups will provide training for parents of children with serious emotional disturbances and the Alaska Mental Health Board will advocate for a requirement that this training be a part of any public managed care system.
115. The Alaska Department of Education will encourage the creation of school social worker positions or other positions to work on social skills training, designing behavior plans for children, etc.
116. Provide training on serious emotional disturbances issues and networking for school psychologists in isolated districts through Project SPRUCE.
117. The Alaska Department of Education will provide training activities for school district staff and administrators to encourage schools to offer varied treatment options for students with behavior problems.
118. Local communities and providers will increase parenting skills by creating incentives to parents to take classes and courses and form parent peer groups.
Goal 5: Encourage more collaborative service delivery models for serious emotionally disturbed children and their families.
Actions
119. The Governor's Council, Alaska Mental Health Board, Alaska Department of Education and others will support combining school and community mental health jobs, creating school social worker positions, and redirecting school psychologists and counselors to a greater prevention and behavioral intervention focus, especially through sharing information with school districts about successful projects.
120. The Alaska Department of Education will ensure through awareness training that school and school-service agency collaboration involves parents as members of the service team.
121. School personnel and service providers will receive needed training in collaborative interagency efforts.
122. The Alaska Mental Health Board, Governor's Council on Disabilities and Special Education, Division of Mental Health and Developmental Disabilities, Division of Family and Youth Services and Alaska Department of Education will explore ways to: reduce delays in records transfer when children move or change programs; standardize forms and intake procedures among programs; and provide continuity of services when children lose eligibility for specific programs.
Goal 6: Increase resources available to teachers and service providers who work with serious emotionally disturbed students.
Actions
123. Provide teachers with directories of community mental health resources and the time to access resources.
124. Encourage collaboration regarding services to children with serious emotional disturbances and their families on the state departmental levels and within communities.
125. Provide joint conference opportunities and shared in service training for teachers of children with serious emotional disturbances and mental health providers.
126. Evaluate and, when appropriate, expand the work of the Special Education Service Agency which is working on community prevention models to reduce the incidence of serious emotional disturbances on a community by community basis.